Topical Issue Debate

Banking Sector

Deputy Shane Ross

Approximately two weeks ago, I attended in succession the AIB and Bank of Ireland AGMs, as a shareholder in one case, I should declare, and as a proxy in the other. They followed a similar pattern. On the platform was a group of overpaid executives. Off the platform in the audience was a crowd of battered shareholders who had had a difficult time in recent years. In the background was a history of exorbitant standard variable rate mortgages. Both banks have executed a punitive regime on their customers in terms of standard variable rate mortgages.

At the time, the banks also had a fourth important characteristic in common, that being, the largest shareholder in AIB, the Minister for Finance. On behalf of the State, he held 99.8% in AIB and 14% in Bank of Ireland.

This was a heaven sent opportunity for the Minister, particularly given the AGMs' timing, to extract extraordinary leverage on those directors and banks to do something about reducing standard variable rate mortgages. He bottled it. At the end of both AGMs, we found out that the Minister had unfortunately cast in favour of all board resolutions. In the case of AIB, these included an increase in the remuneration of the chair by 33% on last year, from €275,000 to €365,000. When standard variable rate mortgage holders are suffering so much, this seems inappropriate. It seems even more inappropriate that the Minister should be casting those votes in the board's favour at a time when the shareholders were suffering so much. An almost bankrupt State voted for an almost bankrupt bank.

I cannot understand why the Minister did not instead tell the board that not only would he not vote for members' remuneration, but that he would not vote for them to be re-elected. He cast his and our votes in favour of re-electing every director at a time when they were approving this policy, eyeballing him and telling him that, no, they would go ahead and do what they liked. The Minister had a great chance. Unfortunately, he did not take advantage of it.

Why did he not do this? What motivated him to vote for these incredible salaries? I believe that I am right in saying that every non-executive at AIB received at least €80,000 in 2014. How that remuneration was earned differed. Sometimes, it was by way of salary because people sat on board committees. At the end of the day, though, they were all getting more than €80,000 per year, the chairman is now getting €365,000 per year, standard variable rate mortgage holders are suffering and the directors are milking the bank.

The Minister should have taken the opportunity to tell them that they would all be gone unless they executed the policy that he wanted, one that he is now trying to force on them, namely, taking the board's foot off the throats of standard variable rate mortgage holders.

Deputy Finian McGrath

Hear, hear.

Minister of State at the Department of Finance (Deputy Simon Harris)

I thank Deputy Ross for tabling this Topical Issue and for the opportunity it provides me to respond on behalf of the Minister for Finance. Let me be clear - the Minister has not bottled anything. He has put in place a clear process in respect of standard variable rates. He has made his own views clear on the records of the House and in many other places, as have the Taoiseach and I during debates in the House. The Central Bank's report on standard variable rates is with the Department of Finance and will be considered by the Minister, who will meet the main banks next week to discuss the issue. A process is in place and I ask that the Deputy not pre-empt the outcome.

The resolutions across AIB and Bank of Ireland covered a number of broad areas: the consideration of the report of the directors, the auditors' report and the accounts for 2014; director-related resolutions, including reports on the directors' remuneration and their re-election; authorisation for the directors to fix the remuneration of the auditors; and technical resolutions allowing the directors certain authorisations relating to the issuance of shares.

Before recommending how the Minister should vote, officials in the Department analysed each of these resolutions. The Deputy made it sound as if the Minister or his proxy just turned up and decided out of the blue. As part of the analysis, officials took into account the fact that ISS proxy advisory services, an expert independent firm that advises institutional shareholders on how to cast their votes at general meetings, recommended that shareholders vote in favour of the Bank of Ireland resolutions. The conclusion of this analysis indicated no reason to vote against the resolutions that dealt with the report of the directors, the auditors' report, the accounts, the remuneration of the auditors or authorisations relating to the issuance of shares.

Regarding the resolutions on directors' remuneration and the re-election of directors, in the normal course investors would vote in favour of such resolutions unless they were dissatisfied with the performance of such directors. It is important that we update our language as regards the banking situation because AIB and Bank of Ireland recorded strong financial results for 2014. Highlights of these results included a significant return to profitability since the onset of the crisis, impressive capital build, significant growth in new lending and good progress in reducing non-performing loans across all portfolios.

The State remains the largest shareholder in Bank of Ireland, with a current minority shareholding of 14%. It is worth noting that, including the State, investors voted overwhelmingly in favour of all Bank of Ireland resolutions within a range of 93.11% to 99.96%. Resolution No. 2, which was to consider the report on directors' remuneration, was passed with 99.73% of votes.

Shareholders in both banks were asked to vote on resolutions covering the receipt or consideration of the directors' remuneration reports. The report is contained in the annual report and accounts of each institution. The acceptance or rejection of these resolutions has no impact on the actual remuneration received by each of the directors.

At the 2014 AIB AGM, shareholders were asked to vote on changes in the structure of non-executive directors' remuneration. These changes moved the remuneration from a fee-per-meeting basis to a fixed annual fee for board membership and an additional fixed fee for membership of each board committee. These changes reduced the amount paid to AIB Group directors by €39,000 versus 2013.

In Bank of Ireland, total directors' remuneration in 2014 was €2.76 million, down marginally on the 2013 total of €2.77 million. Within this total, it is worth noting the following: total remuneration costs, including pension contributions where applicable, for the two executive directors and the governor and deputy governor remained unchanged year on year. Since May 2009, the group CEO has waived a portion of his salary to the sum of €67,000. In addition, in 2014 he waived €51,000 of his pension accrual for the year, resulting in the pension cost to the bank being the same as the cost in 2013. Against this backdrop, to vote against the proposed resolution on directors' remuneration would have been a significant and serious matter and could be perceived as interfering in a commercial entity that could do damage to Ireland and - the Deputy referred to shareholders, the taxpayers - the value of our bank investments. Accordingly, the Minister decided that it was appropriate to vote in favour of these resolutions.

Deputy Shane Ross

I have rarely heard a weaker case made in this House for bankers’ pay. I am not surprised and do not blame the Minister of State because he is carrying the can for a decision that was made elsewhere. I am not surprised to hear him state aggregate levels have gone down slightly. The fact is that he did not address the issue. How can he support an increase of 33% in the pay of the AIB chair? The profits he quotes are questionable. He knows that because it has a lot to do with what one allows for bad debts and how one provides for them. One can control the banks' profits. They made huge reductions, which are questionable this time, but the chairman got a 33% increase. That is not excusable at this time.

Consider the Minister of State's statement that 99% of investors voted in favour of the decision. He is correct in the case of the Bank of Ireland. In the case of AIB, 100% voted in favour of the decision, which was even worse. It is disingenuous for the Minister of State to say here that the shareholders voted in favour of the decision. He, and certainly whoever wrote his script, well know that the big shareholders are the people who voted. A vote by the small shareholders would certainly result in a large majority voting against the pay. The chairman of Bank of Ireland gets a lot more than the chairman of AIB. He gets €490,000 in a remuneration package. He is a man who, with the chairman of AIB, is simply a refugee from British banking. The United Kingdom is where they were found. Neither of them was wanted in the United Kingdom. They land over here and get huge sums of money, €500,000 per year in one case. That is inexcusable. The Minister voted in favour of Mr. Richie Boucher, the chief executive, getting a package of €843,000. Let us justify that.

Acting Chairman (Deputy Olivia Mitchell)

The Deputy should not refer to people who are not here in a disparaging manner.

Deputy Shane Ross

I am sorry. It is a fact, though. The Minister did vote for the chief executive. I apologise if I was out of order.

We do not have an answer to these questions at a time when the Minister is also approving the banks' activities, which involve taking on, crucifying and punishing the standard variable rate mortgage holders. It is no good for the Minister to come in here and ask us to wait to see what happens next week. He had a great opportunity to say he would not vote favourably unless the bank did something about the unfortunate mortgage holders but he bottled it. He could have done what I describe, sacked the board and put in his own people who would change the policy of the banks.

Deputy Simon Harris

I get confused sometimes as to what Deputy Ross would actually like to happen with the banks. Sometimes I cannot help but think that, unless he and Deputy Finian McGrath were running the banks, he would not be pleased with the performance of anybody running them. The reality is that the Government has to take a holistic view. Deputy Shane Ross talks about shareholders, the taxpayer and the small person. These are people who want to know that every cent of taxpayers' money pumped into the banking system, or at least into the live banks and not the zombie banks that Fianna Fáil put money into, will be recouped.

I have heard Deputy Ross speak eloquently and correctly about the need for more competition in the banking sector, yet he wants the Minister for Finance running around from bank to bank trying to run them. The banks are commercial entities. Our job is to get out of the business of owning banks, we do not want to own them. I have made it very clear to the Deputy in my initial response that some of the votes actually cast at the AGMs reduced the cost of directors' fees this year and last year.

Deputy Shane Ross

The aggregate cost.

Deputy Simon Harris

Yes. The cost to the taxpayer was reduced.

Deputy Finian McGrath

By €39,000.

Deputy Shane Ross

By €39,000. Come on.

Deputy Simon Harris

We tend not to heckle during Topical Issue debates. The reduction seems to have been completely ignored.

In Bank of Ireland, to which the Deputy referred, we have a 14% shareholding. The State is a minority shareholder, yet we saw these resolutions passed by the overwhelmingly popular vote of shareholders. We want to get every single cent of money back out of our banking system. We are not giving up on the standard variable rate issue. Deputy Ross referred to the great chance the Minister had. The Minister has a process in place. We made it very clear in the Spring Economic Statement. The Minister will bring in the all the bank representatives next week and we will work on the issue. The rates are too high and need to come down. The Government is committed to that. However, it is easy to be populist in these matters. The Government cannot afford to be. It must get every cent of the money back for the taxpayer.

Deputy Finian McGrath

Never be populist.

Domestic Violence Refuges Provision

Deputy Pat Rabbitte

I understand that the Minister for Health is engaged in the other House but I want to bring to his attention, as I am sure does the Minister of State, Deputy Dara Murphy, the plight of Cuan Álainn, a women’s and children’s refuge in Tallaght. It was founded in 2012 by the housing association Respond! and has provided a safe harbour for some 64 for women and 84 children since then. It is a refuge with a difference in so much as it is a second-stage facility designed to provide temporary accommodation and advice to women referred by emergency refuges or other State agencies. Without such a facility, women and children have no choice but to return to abusive partners or be allocated to accommodation for the homeless. Expert opinion suggests the service is necessary and value for money.

Respond! undertook in 2012 to fund this service for three years. It can no longer do so. The annual cost is somewhere between €320,000 and €350,000. Respond! is now confronted by what it says is an unavoidable decision, to close Cuan Álainn. State agencies, including Tusla, accept that Respond! has identified a definite need to care for women and children who must move on from emergency refuges. The typical stay may be from six to nine months while alternative arrangements are made to procure housing for the women and children concerned. I accept the budgetary situation remains difficult and that, in particular, the Tusla budget is under pressure. However, it would be shameful if Cuan Álainn were allowed to close because it serves a huge catchment area where the need is great, as the Acting Chairman, Deputy Olivia Mitchell, knows.

I thank the Minister of State for taking this issue. I ask him to examine whether steps can be taken to protect the service. By way of being helpful, I suggest respectfully that, in the short term, he engage with his colleague the Minister for the Environment, Community and Local Government, Deputy Alan Kelly, to examine whether it is within the competence of both Departments to save the service from closure. If it does close, it will be axiomatic that the cost to the State to provide alternatives will be more expensive.

Minister of State at the Department of Justice and Equality (Deputy Dara Murphy)

I apologise on behalf of the Minister for Health, who is not available at present. I thank Deputy Rabbitte for raising this topical and important issue and I welcome the opportunity to clarify the Government's approach to the funding of domestic violence services generally. Cuan Álainn, as Deputy Rabbitte has said, provides second-stage accommodation for women and children who are experiencing domestic violence and who may have been in emergency accommodation. The centre opened in 2012 and is funded by Respond! Housing Association.

Tusla, the Child and Family Agency, allocates available funding for domestic violence to emergency refuge accommodation services and community-based domestic violence supports. Tusla endorses the use of second-stage refuge and supported accommodation to enable people to move on from emergency accommodation. While it does not currently fund such services, it has indicated that it hopes to support them in the future based on the direction it intends to pursue. Tusla met Respond! recently and advised that, as matters stand, it is not in a position to fund this service in the current year.

It might be helpful for Members if I share some background to the arrangements for dealing with this issue at a strategic level.

Due to the complex nature of the issues involved in domestic and sexual based violence, and the need for a coordinated and effective response to these issues, the National Office for the Prevention of Domestic, Sexual and Gender Based Violence was established as an executive office in the Department of Justice and Equality in 2007 and that Department currently has overall policy responsibility in this area. It has formulated a comprehensive cross-Government strategy, which combines the efforts of a very broad range of organisations and individuals, to combat all forms of domestic, sexual and gender based violence. The national office is currently in the process of finalising a new cross-sectoral strategy from 2015 onwards.

In terms of service delivery, Tusla which was established on 1 January 2014, has taken on responsibility for the provision of domestic, sexual and gender-based violence services which were previously funded by the HSE. For the first time this service is under national direction. We now have a single line of accountability and a consolidated national budget which is reserved for allocation to these particular services. Domestic, sexual and gender-based violence services can now be delivered within a broad child and family support framework and this represents a significant change to the previous service delivery model.

Tusla will continue to work closely with service providers to ensure that women and children fleeing domestic abuse receive all necessary support and the position in respect of the Cuan Álainn service will be kept under review.

Deputy Pat Rabbitte

I thank the Minister of State for his response. It seems that the broad orientation of policy he outlined is probably correct. The tragedy, however, is that if we let this facility close it would be very difficult to re-establish it.

The Minister of State made the point in his response that Tusla has indicated that it would hope to support such services in the future but in 2015 this particular refuge is in crisis. The funding required to keep it open for the remaining half of the year is not a very large amount. It was supposed to close down in March, as the commitment given was that it would be funded for three years. We are up against it now as we face into the remaining half of the year.

I did not appreciate fully that there is a role, as envisaged here, for the Department of Justice and Equality. Respond! has also a connection evidently with the Department of the Environment, Community and Local Government. I know things are tight. I hear their lordships on radio complaining that the cut in the Tusla funding to Accord is retaliation by the Government because of the prominent role of some Catholic prelates in the equality referendum. They seem prepared to ignore the assurance of the Minister that it was not so. The refuge in Tallaght certainly is not involved in the referendum. That is not the reason funding is being cut. It is clear to everybody, and ought to be clear to their lordships, that Tusla has a funding problem, having taken over new responsibilities this year.

In respect of this particular initiative by Respond! which is acknowledged by all the agencies involved, by the HSE, the emergency refuges around south Dublin and the county council, as being a splendid service where women fleeing domestic violence, who do not have any other alternative except to go back to the abusive partner, have a facility to move on while housing is being procured for them. It is a very valuable initiative. It represents value for money. The alternative would cost the State more.

I ask the Minister of State to engage with the Minister for Justice and Equality and the Minister for the Environment, Community and Local Government to see if a half year's funding for the refuge can be put together while the new model of service he spoke about can be settled on by the respective Departments.

Deputy Dara Murphy

I would agree with the Deputy's comments. Respond! does excellent work and any suggestion of any ulterior motives, as the Deputy said, would be erroneous in the extreme.

I take on board the point about the ambition for future years that is clearly expressed in the reply I gave to the Deputy's important Topical Issue matter. I will raise the issue, responsibility for which is spread across three Departments, with the Minister for Health and also with the other two Ministers concerned and make them aware of the shared responsibility in this respect, and I will ask them to revert to the Deputy with their responses.

Drugs Payment Scheme Coverage

Deputy Paul J. Connaughton

I thank the Ceann Comhairle's office for selecting this matter for the Topical Issue debate and I thank the Minister of State for being present to take it. When it was selected I had a four-minute speech prepared outlining the background to this issue and then I thought what is the point of doing that as anybody who does any background check will find all the parliamentary questions that have been tabled on the issue. I would say it has been raised by every Deputy in the House at some stage during the past year. Therefore, I will not bore the Minister of State with the background story to this issue, of which she is only too well aware.

Like every other Deputy, I have been contacted by numerous people in recent weeks and months. It is only when one reads of or listens to the human stories of the people involved that one fully understands how the non-availability of this drug is impacting on people's lives. I was contacted recently by one woman whose life has been significantly curtailed since she finished on the drug. She can no longer walk as far as she once could and her balance is greatly affected, which makes her more fearful in terms of walking and greatly reduces her independence. Another woman who wrote to me spoke of her anger at being failed by the State, particularly as she knows that many others are in a similar position, having their lives curtailed because of decisions made purely on economic grounds when there is a very human cost to these decisions.

I know the Minister of State is very well aware of this issue. The first Topical Issue debate on this issue took place on 10 June last year but responses to parliamentary questions on 6 May of this year indicate that this issue has not been moved forward much on the basis that the responses state that the company has re-applied again to submit this drug under the schemes and that the Department and the HSE are working with it. The problem is that this has been going on for a year at this stage. Multiple sclerosis sufferers are no further along the line of knowing what the Government can do in their cases and their lives are being terribly curtailed and impacted by the lack of information.

I would like to find out today where those negotiations are at. If the problem is with the pharmaceutical company that is involved, it is important that we would know that. Who is handling the negotiations? When was the last date a meeting took place on this issue? Is it possible to move this topic on, even a little today, for us to be able to say to multiple sclerosis sufferers that we are concerned about where we are at with this process.

I know full well that the drug does not work for everybody but for those for whom it does work, it seems to be a life-changing experience for them. We must be careful and understand that if we can make a difference in one person's life, it would be a major achievement if we could get this drug included under one of the free schemes. I understand the Department of Health more than any other Department has huge cost containment issues because everybody wants to get the drug that will help save their lives included under the schemes, but if the inclusion of this drug can help change even one person's life, including those women I mentioned in Galway, I would urge the Minister of State, the Minister, Deputy Varadkar and the Government to get this drug included under the scheme as soon as possible.

Minister of State at the Department of Health (Deputy Kathleen Lynch)

I thank the Deputy for raising this issue. He is right in saying that it has been raised on numerous occasions. It is not as if we are unaware of or sympathetic to the circumstances in which people find themselves. We have personal experience of this in that we know people who are desperately awaiting some relief in respect of this issue.

Decisions on which medicines are licensed for use in Ireland and which are reimbursed by the taxpayer are not political or ministerial decisions. These are made on objective, scientific and economic grounds by the HSE on the advice of the National Centre for Pharmacoeconomics. The HSE has statutory responsibility for decisions on pricing and reimbursement of medicinal products under the community drug schemes in accordance with the provisions of the Health (Pricing and Supply of Medical Goods) Act 2013. At the outset I would like to clarify that fampridine, the brand name of which is Fampyra, was never available to multiple sclerosis patients under the general medical services and community drugs schemes. However, I understand that the manufacturer of fampridine supplied the drug free of charge to some patients who were prescribed the drug by their clinician.

The manufacturer has stopped supplying the drug free of charge, thereby requiring patients to finance the drug if they wish to continue with the treatment.

The HSE received an application for the inclusion of Fampridine in the GMS and community drug schemes. In accordance with agreed procedures, the National Centre for Pharmacoeconomics conducted an evaluation of the drug. The evaluation, published in 2012, concluded that the centre was unable to recommend reimbursement of the product as the manufacturer was unable to demonstrate sufficient effectiveness and a fair price for Fampridine in the Irish health care setting. On foot of this, the HSE decided that it was not in a position to add the drug to the list of reimbursable items supplied under the GMS and other community drug schemes. The manufacturer submitted a new application to the HSE on 25 July 2014 for the inclusion of Fampridine in the community drug schemes. The HSE's corporate pharmaceutical unit has since been engaging with the company seeking improved commercial offerings and the HSE is considering the outcome of these commercial engagements. It has also had discussions with clinical experts about this drug, the outcome of which is also being considered.

The HSE and I fully understand the concerns of patients about the availability of this drug, but it is not possible for the taxpayer to reimburse every licensed medicine at whatever price a drug company demands. It is important that we get the best possible price for this drug which is of benefit to some people. It is fully understood Fampridine benefits some, although not all, MS sufferers. At the same time, it is our duty to ensure we get the best possible price for the taxpayer in this instance. The negotiation process has concluded, but I am not saying that is the final word on the matter. We are looking at the outcome of the negotiations but have not yet come to a final decision.

Deputy Paul J. Connaughton

I thank the Minister of State for her response, but the concern of MS sufferers all over the country is that her response has not changed a lot in the past six or 12 months. I have raised the issue again today and while I understand negotiations to which I am not privy have concluded, it appears that we have not moved even one little bit. I ask the Minister of State to give some indication as to when she believes we will get an answer to this question. I am not looking for a specific date, but it is very important that some indication be given to MS sufferers who see no grounds for hope. They cannot afford this drug which is simply too expensive. To make matters worse, they saw the difference it had made to their lives but then it was taken away from them owing to the expense involved. We cannot continue with a situation where all questions tabled by elected representatives on this issue are answered in the same way. We cannot see the finish line. If we do nothing else today, can we, at least, receive a indication as to whether a decision will be made in six or 12 months? When will the HSE make a decision on whether it will cover the cost of this drug for MS sufferers?

Deputy Kathleen Lynch

My opinion on when we will have an answer is irrelevant. What we need to do is ensure the drug is affordable for the State. It was withdrawn by the drug company involved. Fampridine was never available under the GMS or the drug refund scheme. It was both cruel and unfortunate for people who had obtained huge benefits from it when it was withdrawn. We are still looking at the question of whether it is affordable. That may sound cold and callous, but I do not mean it to come across in that way, as I understand the difference the drug has made to peoples' lives. We are doing our very best to ensure something that will benefit people will be available to them. However, there are cases where drugs are simply unaffordable. I understand this might appear to be a harsh decision, but we have not given up. We are still looking at the issue. I hope whatever decision is made, whether good or bad, will be relayed to patients as quickly as possible because it is equally cruel to leave them hanging on.

HSE Investigations

Deputy Caoimhghín Ó Caoláin

I welcome the Minister of State. While I am sorry the Minister for Health, Deputy Leo Varadkar, is not present, I understand the reason for his absence.

It is very regrettable that I have to raise this issue and I know that the Minister of State agrees with me when I say that. The death of another newborn child in Cavan General Hospital yesterday is a very serious and troubling matter. This is the fourth newborn child to be lost in the maternity unit at the hospital in the past 30 months, within which time we have yet to see findings or recommendations in respect of any of the previous tragic outcomes. That is compounding the serious impact all of these outcomes have on the confidence of a dependent community in Cavan, Monaghan and neighbouring counties. It is absolutely imperative that the Minister and his Department intervene immediately to ensure the reports under preparation following the conclusion of the investigations of those given the responsibility to carry them out are brought forward with all due speed and published. In that way, people will have the opportunity to see the findings and recommendations made and very quickly thereafter the implementation of same. It is very reasonable and understandable that many people in the constituency in which I live and which I am honoured to represent believe because of the absence of findings and recommendations, including in the very first case, that of baby Jamie Flynn in November 2012, that the subsequent tragic outcomes could have been avoided if the full gamut of information had been available and the necessary steps taken. Sadly, there was yet another case yesterday.

I ask the Minister of State and the senior Minister to intervene with Dr. Peter McKenna, Professor Tom Mathews, Ms Dawn Johnson and Ms Margaret McGarry to encourage the employment of the maximum number of hours available to them and more, if possible, to expedite the conclusion of their investigations. Let us not forget that this is the second investigation into this matter, as the report on the first investigation was suppressed by a decision of the High Court following a case taken by one of the practitioners directly involved.

I am also anxious to establish the nature of the engagement by the former Minister for Health, Deputy James Reilly, with HIQA when he announced publicly in Cavan that he would secure HIQA's attention for the cases in Cavan, in association with the authority's investigation into and report on the tragic outcomes at the Midland Regional Hospital in Portlaoise. It appears from the information to hand that no such direct order was issued by the former Minister, despite his public commentary, and that HIQA has not carried out any investigation or paid any "particular attention," to use his words, to the cases in Cavan in the intervening period. I ask the Minister of State to shed light and offer clarity on the issue.

What is the most up-to-date assessment of when the second investigation into the death of baby Jamie Flynn is likely to be concluded?

Deputy Kathleen Lynch

I should clarify for the House that the Minister for Health is not present to deal with this Topical Issue because he is meeting the families involved in the aforementioned tragedies at the Midland Regional Hospital in Portlaoise. I am sure the Deputy will agree that the Minister is right to meet them.

I thank the Deputy for raising this issue and affording me the opportunity to offer my sincerest sympathies to the family at the centre of this sad incident. I am very conscious of their personal tragedy, and do not, in any way, want to intrude on their privacy. It is important at this time that we give the family the space to grieve and I am sure they are grieving.

Of course, the HSE will undertake a review of the circumstances of the case and in so doing will follow the HSE incident management policy. Pending the outcome of that review, it is not appropriate for me to make any further comments on the specific incident. HIQA will conduct a focused programme of monitoring of compliance with the National Standards for Safer Better Healthcare across maternity services nationally. This programme will include the maternity unit at Cavan General Hospital and will be undertaken this year.

Concerns were raised regarding maternity services in Cavan following the deaths of three babies between 2012 and 2014. Following the death of the third baby in May 2014, the previous Minister for Health, Deputy Reilly, wrote to HIQA requesting that priority be given to a review of the maternity services in Cavan General Hospital against the national standards. I understand that HIQA has made contact with the HSE and details of the three incidents have been furnished to the authority.

With regard to the specific infant death referred to by the Deputy, the investigation into this tragic incident is still under way. I can make no further comment at this time. We are, of course, all too painfully aware of the events detailed in the HIQA report into maternity services at Portlaoise hospital. The Minister, Deputy Varadkar, briefed this House on the findings of that report yesterday and Deputies will be aware of his views on the failings in our services as detailed in the report.

I assure the House that action is being taken to address the serious concerns raised in the HIQA Portlaoise report. The Minister, Deputy Varadkar, has decided to establish a national women and infants health programme to address and improve maternity services across the country. The programme will provide the cross-sectoral framework and the necessary governance, integration and leadership to drive reform and standardise care across all 19 maternity units.

One of the Minister's priorities for 2015 is the publication of the national maternity strategy. The strategy will provide the policy to underpin the women and infants health programme. The steering group to advise on the strategy met for the first time last week and had a very useful engagement. The group is expected to report to the Minister before the end of the year. I believe it is expected in October.

I wish to clarify one other issue before the Deputy stands up because I do not want him to be wasting his time. I have a copy of a letter from the previous Minister for Health to Mr. Brian McEnery, the chairperson of HIQA. It outlines the concerns over Cavan General Hospital's maternity unit and the events there. In his letter the Minister requested HIQA to prioritise the monitoring of the maternity unit at Cavan General Hospital. Unfortunately, that request, as far as I know, has not been carried out, but it would be re-emphasised at this time.

Again not to have the Deputy wasting his time when he stands up for his second intervention let me also say that there is a very delicate balance over what Ministers can say to HIQA while not having that seen as an intrusion on its statutory and separated powers from Government. That is a line we all tread every day.

Deputy Caoimhghín Ó Caoláin

I assure the Minister of State that I never waste my time when I get the opportunity to speak in this House. I will have the opportunity to query the address of the Minister to HIQA in a few moments when I return to the Joint Committee on Health and Children before which Mr. Phelim Quinn is appearing this afternoon. However, I understand that the request does not equate with an order and there seems to be some differential between the two. This is most unfortunate and needs to be properly addressed.

I note the Minister of State's inability in her reply to refer to the second investigation. I named the make-up of that team in my first contribution. Irrespective of what restrictions may exist, I ask the Minister of State in her further reply to indicate that she and the Minister would urge the participants, Dr. McKenna et al., to increase focus in terms of the utilisation of their time, accepting that they are all already very busy people in other areas but recognising that we cannot afford to wait for the third anniversary of the tragic loss of baby Jamie Flynn by November of this year before we are to see even the publication of the report never mind the implementation of its recommendations.

Among a significant catchment of this country, pregnant women presenting for obstetric maternity services are deeply concerned. Staff in the maternity unit in Cavan General Hospital are also deeply concerned at the absence of any report findings and recommendations. I have no question as to the integrity and commitment of the maternity staff, the nurses and midwives, at Cavan General Hospital. They are understandably anxious to have this matter expedited. It is imperative that particular action is taken and that we have the required closure in terms of those findings and recommendations at the earliest possible time. I thank the Minister of State for her co-operation on that.

Deputy Kathleen Lynch

I share the Deputy's frustration over the inability to publish certain reports. We must find a way of on the one hand allowing people named in reports to have due process if that is what they want but on the other hand being able to publish the relevant information in order for us to take the necessary steps. The non-publication of the report does not mean that the necessary steps cannot be taken, because clearly it is seen by the people in the system.

However, in the instance that has brought us here today, an investigation team is already being set up. It is just over 24 hours since that baby died. A serious reportable event report is being prepared by the hospital. The case is logged in the incident investigation and management system, and is being escalated. An investigation team has already been established. The coroner has been contacted and the appropriate paperwork is being completed.

The HSE is not currently aware of any wider patient safety concerns arising from this case. That is important because we are talking about people who are at their most vulnerable. For a pregnant woman, going into labour is probably the most vulnerable time in her life. The necessary steps are being taken over that incident.

There is a wider issue with maternity services across the country, and not just in Cavan and Portlaoise. We need to determine what we need to do in order to restore trust and give women the reassurance they need regarding maternity services. The group appointed to prepare the maternity strategy will do that for us. However, the things that need to be done regarding Cavan General Hospital are already in train.

Dáil Éireann debate - Wednesday, 13 May 2015